- 期刊
針藥並用治療幻肢痛之病例報告
Acupuncture and Chinese Medicine Combined Treatment of Phantom Limb Pain:A Case Report
摘要
本病例為65歲女性，民國94年7月發生車禍左下肢嚴重受損而接受膝上截肢手術（above-knee amputation），術後左下肢逐漸產生幻肢疼痛，以前側及後側麻痛感為主，後因遭逢家人相繼過世而感到難過，使得幻肢痛加劇。患者曾有多次自戕史，後經身心科診斷有輕鬱症，服用西藥控制中。患者於民國111年7月就診於奇美醫院大內偏鄉巡迴醫療，來診時需仰賴四腳拐行動，眼神亢奮、手腕部陰面多處疤痕。經中醫經絡辨證為足太陽與足陽明經氣滯血瘀痰阻；中醫臟腑辨證則為心陽有餘，心神失守，氣苑於上，痰蒙清竅。針灸穴位取雙側靈道、右側養老、手三里、承山、大椎等。出針後VAS由原先5分降為1分，配合內服中藥溫膽湯合柴胡龍骨牡蠣湯加減，複診表示幻肢痛改善許多，有時不會疼痛。患者居偏鄉，加上肢體障礙、肢體不便，中醫師配合政府照顧偏鄉的政策至偏鄉服務，解決患者身心苦惱。可見中醫藥簡便效佳的特點，值得衛生單位多加推廣。
並列摘要
This case is a 65-year-old female suffering from phantom limb pain after undergoing a left above-knee amputation secondary to a major car accident in July 2005. Even worse, her pain extremely increased after she losted family members one after another. The patient had committed suicide many times, and had been diagnosed with mild depression under control of psychiatric medicine. She sought for pain-relief methods at the Chi-Mei Hospital Rural Health clinic in July 2011. According to traditional Chinese medicine(TCM) pattern identification, she was diagnosed of phlegm clouding the orifices, ascendant hyperactivity of liver yang, and malnutrition of heart spirit. On the other hand, based on the pattern identification of the Meridian, the patient was diagnosed as qi stagnation, blood stasis and phlegm obstructing in bladder meridian and stomach meridian. Thus, we chose acupuncture points including bilateral Lingdao(HT4), right Yanglao(SI6), Shousanli(LI10), Chengshan(BL57), Dazhui(DU14). As soon as the needle removed, the visual analog scale of pain was reduced from 5 to 1. Together with several Chinese medicine powder of Wendan Decoction and Bupleurum Longgu Muli Decoction, the follow-up visit showed that the phantom limb pain improved tremendously. This experience showed that acupuncture and Chinese Medicine plays an important role in the relieving of Phantom limb pain. Besides, this is also a successful example of rural health care system that the simplicity and effectiveness of Chinese medicine is worth promoting in improving the health care of rural patients.